Probably the first thing that comes to mind when you asked the question is a big misperception about having cesarean sections, and that is that it’s an arbitrary process. Usually when people have a cesarean section it’s because of a very clear indication for having c-section and there’s very little discretion involved.
Discretion comes into play maybe in two general areas – one would be the interpretation of the fetal tolerance of labor. So there’s a little bit of, you know, discretion there by the doctor, and the other is discretion by the patient.
People who have had a prior cesarean section, want a trial of labor or want to have a repeat cesarean section, and whether it’s in vogue or a fad now, we are actually having people who want primary cesarean sections to preserve or protect their pelvis, which is common in other cultures.
To answer the question directly, why don’t you want to have surgery, well, basically because it’s surgery. It comes with all the risks of having a major surgical procedure, even though it is very, very commonly performed and the vast majority of women do very, very well, it still carries with it a risk of infection, bleeding, injury to organs around the uterus, the uterus itself, which could result in loss of future fertility or the ability to get pregnant in the future, and, you know, even death, though it’s very, very rare that those things would occur.
The other things that people don’t kind of think about is that after you’ve had one cesarean section, you may be interfering with your chances of being able to have vaginal delivery in the future as trends change and people, once they have had a cesarean section are encouraged to have it again. And it can also affect the way the placenta implants into the uterine wall for subsequent pregnancies and can lead to complications in subsequent pregnancies related to placental implantation.